Preoperative and postoperative risk factors in laparoscopic cholecystectomy converted to open surgery

Abstract

Ekici U, Tatlı F, Kanlıöz M. Preoperative and postoperative risk factors in laparoscopic cholecystectomy converted to open surgery. AbstractBackground. Laparoscopic cholecystectomy (LC) is nowadays the gold standard in the surgical treatment of cholelithiasis and gallbladder diseases. But sometimes it may be inevitable to convert it to open surgery to safely end the procedure.Objectives. In this study, we aimed to investigate the risk factors for conversion to open surgery from LC.Material and methods. The records of patients that underwent LC in Malatya State Hospital (Malatya, Turkey) between January 2013 and May 2014 were prospectively examined. One hundred and forty-five patients were involved in this study. The patients were divided into 2 groups: LC patients and patients converted to open surgery. For the patients in both groups, the preoperative age, gender, body mass index (BMI), disease history, previous abdominal operations, and preoperative laboratory findings were recorded, as well as the fact if the abdominal ultrasonography (US) and endoscopic retrograde cholangiopancreatography (ERCP) were performed. Results.Of 145 patients involved in this study, 127 (87.5%) were female and 18 (12.5%) were male; their mean age was 46.54 years. Nineteen of the patients were operated on after ERCP due to acute cholecystitis and 6 patients were operated on after ERCP due to choledocholithiasis. In 134 of the patients (92.4%), the operations were completed laparoscopically, while the process was converted to open surgery in 11 cases (7.6%). Male gender, chronic disease history, normal BMI level, increased thickness of the gallbladder wall, increased preoperative blood glucose level, leukocytosis, preoperative ERCP history, grade 3 or 4 (Blauer scoring system) adhesions determined during the operation, and multiple stone presence in the bladder were found to be statistically significant risk factors for conversion to open surgery. Conclusions.Patients in the risk group should be informed by experienced laparoscopic surgeons about the potential conversion to open surgery and decision on such conversion should be made when necessary.

Gallbladder adhesion degree as predictor of conversion surgery, common bile duct injury and resurgery in laparoscopic cholecystectomy: A cross-sectional study

“…The analysis shows that degree of GB adhesion has a significance, albeit low degree of correlation, for conversion to open surgery. This aligned with many previous studies which stated that GB adhesion is significant risk factor for conversion surgery [ [15] , [16] , [17] ].…”

Effects of the timing of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography on liver, bile, and inflammatory indices and cholecysto-choledocholithiasis patient prognoses

“…The two therapeutic regimens did not statistically differ in terms of time to the first passage of gas through the anus, the length of postoperative hospital stay, and the stone-free rates, but the average surgical time was shorter and intraoperative blood loss was less in LC 1-3 d after ERCP. A possible reason for this finding is that edema in the Calot's triangle occurred after ERCP due to the surgical wound, which mainly occurred 72h after surgery and worsened continuously, thus increasing the difficulty of LC 4-7 d after ERCP, resulting in prolonged surgical time and increased blood loss (13,14). According to the results of this study, the liver functions and bile biochemistry of both OG and CG improved, but these changes were not statistically significant.…”

The Analysis of Risk Factors in the Conversion from Laparoscopic to Open Cholecystectomy

“…So far, the literature has shown many inconsistent factors that may result in the need to convert laparoscopy to open surgery in the treatment of gallstone disease. Among them, factors such as inflammatory infiltration, acute cholecystitis, age, sex, or coexisting diseases were found [ 4 , 8 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. However, there are no reports on the time of day of laparoscopic cholecystectomy and its effect on the conversion to open procedure.…”